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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Chronic Liver Parenchymal Disease

My mother is 63 years old and suffering from Chronic Liver Parenchymal Disease with swollen portal vein and Ascites fluid. All the symptoms match like swollen legs & feet, continuous coughing and problem of short breathing. As doctor say, she is in her third stage of said disease. Recently the ascites fluid was drained out and it was about 2.5 litres. The sme was analysed and one of the report revealed her protein to be 2.5, RBC as +; WBC-800 & lymphocytes to be 100%. Would like to understand what this disease is and how far her liver is functioning. Her health is deteriorating day by day and she is loosing weight. We would like to know in which direction her treatment should start..rather what is the next step and probable medicines to be given.
Fri, 17 Apr 2020
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Internal Medicine Specialist 's  Response
Hello,

Unfortunately Chronic liver disease is not a curable condition. It can arise due to various reasons like prolonged diabetes, viral hepatitis, certain alternate medications etc. In CLD the liver functions are compromised.

The protein albumin decreases and pressure in the portal vein increases (as the liver gets shrunk). This leads to fluid accumulation in the abdomen (ascites) and swollen legs (oedema).

Fluid overload in the body and ascites can cause breathing difficulties. It is important to check the ascites fluid as it may get infected and an antibiotic course is needed in that cases.

There is no specific treatment for CLD. The mainstay of therapy is supportive like prevention of constipation (by lactulose syrup), prevention of bleeding (by Vitamin K injection), drainage of the ascitic fluid, intravenous albumin etc.

The liver function tests (including INR) and complete blood counts need to be monitored. Your Gastroenterologist may plan for an endoscopy to check for an venous swelling in the oesophagus.

You just need to monitor for some dangerous signs like confusion, severe abdominal swelling, black stool, bleeding from any site.

I can just advise to reduce the salt intake in the diet and fluid restriction (depending on urine output). The medical therapy needs to be discussed with your gastroenterologist in details.

The only definitive therapy availability for a decompensated chronic liver disease is a liver transplant, which I am sure your doctor must have explained about (the risks and benefits involved).

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr. Ayusmati Thakur
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Suggest Treatment For Chronic Liver Parenchymal Disease

Hello, Unfortunately Chronic liver disease is not a curable condition. It can arise due to various reasons like prolonged diabetes, viral hepatitis, certain alternate medications etc. In CLD the liver functions are compromised. The protein albumin decreases and pressure in the portal vein increases (as the liver gets shrunk). This leads to fluid accumulation in the abdomen (ascites) and swollen legs (oedema). Fluid overload in the body and ascites can cause breathing difficulties. It is important to check the ascites fluid as it may get infected and an antibiotic course is needed in that cases. There is no specific treatment for CLD. The mainstay of therapy is supportive like prevention of constipation (by lactulose syrup), prevention of bleeding (by Vitamin K injection), drainage of the ascitic fluid, intravenous albumin etc. The liver function tests (including INR) and complete blood counts need to be monitored. Your Gastroenterologist may plan for an endoscopy to check for an venous swelling in the oesophagus. You just need to monitor for some dangerous signs like confusion, severe abdominal swelling, black stool, bleeding from any site. I can just advise to reduce the salt intake in the diet and fluid restriction (depending on urine output). The medical therapy needs to be discussed with your gastroenterologist in details. The only definitive therapy availability for a decompensated chronic liver disease is a liver transplant, which I am sure your doctor must have explained about (the risks and benefits involved). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ayusmati Thakur